Trying again after M/C- long soory!

AngieLong328 · 08-07-2009, 06:07 PM

I post this thread with much anxiety. To start from the beginning- I got pregnant using Femara and a trigger shot. We were so excited! Everything was going along without any signs of problems- All the lab work was normal, we were expecting a baby girl this October. All the problems began the night after my anatomy scan( 20 wks 5 days). I noticed that I was leaking fluid- I talked to a friend who works in L & D and told her everything was perfect on the scan- she said to come in or call first thing in the morning. I opted to wait until the morning. When I woke the situation has worsened the fluid had drastically increased and I immediately made an appointment to see my DR.- Of course they gave me the worst news of my life- my membranes had ruptured. At that point we decided we still wanted to give her a chance and opted for expectant management. I was admitted and started on IV antibiotics- with the hope of rebuilding fluid levels and avoiding infection. The next morning I went to see a perinatologist and we were not prepared for what they had to say. I had rapidly and painlessly dilated to 5 cm and her little leg had slipped through the cervix. Of course at this point, we had no option other that to induce labor. Shortly after the induction, I had a complete abruption. So thankfully I was asleep when she was delivered and did not have to endure that pain. There were no apparent abnormalites- she was obviously too small to survive at 21 weeks, but she did weigh whopping 14.8 oz and 11 inches long. Even while I was in the hospital, I knew I wanted and needed to try again. My anxiety surrounds my latest attempts to conceive. I have 101 questions and doubts. They could never give me a concrete reason for the M/C, but since that time I have found out that I have 4 clotting disorder mutations (found out when they ran a thrombophilia panel PAI-1, MTHFR, Facto V, and cardiolipin). I chose not to return to the ob/gyn that delivered the baby because they said they would handle the pregnancy the same ( we had not recvd' the results from the thrombophilia panel at this time) except they would do serial cervical lengths. I am sure there is nothing else they can do, but this next time I can not live with any regrets. I need to know that I have done everything possible to protect my unborn child. My husband thinks I am sort of crazy- but I don't think I could survive a loss like that again. My question is how to try to survive the hope or future pregnancies without going crazy with doubts and fears?????

justagirlgirlgirl · 08-08-2009, 01:30 AM

Angie - I haven't had a second trimester loss so I can only begin to imagine what you're going through.

I do think that it will be impossible to ever have a pregnancy that isn't riddled with fear and concern. It is only human - after suffering such heartbreak how can you put yourself back in the same position again?

The best thing that you can do, IMO, is educate yourself and find a doctor who is willing to support you 100%. Do they believe that you had an incompetent cervix? There are several girls here who have gone throught that and there is a lot of good info if you look in their thread. Find out how you can take steps to protect your baby if that is the case.

And, make sure that you feel that your doctor is sympathetic to your needs and willing to do whatever it takes to a) prevent another loss and b) help you feel comfortable and reassured.

For example, my OB is very open and understanding...when I expressed my concerns after a first trimester loss, she told me to come in as often as I needed. When I told her that I was getting anxious at the end, she told me again to come in and get checked if I was worried. Fortunately my last pg was uneventful, but I felt like I could rely on her to help me through any concerns that came up. And in your case, that is definitely what you need.

Sorry I don't have any great answers, but hopefully you can get some more responses, too, from people who have been in your situation. hugs!

TDoern · 08-08-2009, 01:49 AM

Angie -

I have no idea how long ago, or recently this loss for you was, but I am so sorry for your loss. I have to tell you that the scariest thing about what you've shared is how similar it is to my same story - even to the point of having a foot kick through the cervix.

I was told by my doctors that I have an "incompetent" or "insufficient" cervix. Meaning my cervix was not strong enough to hold the baby in. Given what you've said, and the fact that you were dialated, the water sac coming through, everything, I can't believe this wasn't mentioned - unless by your membranes rupturing that's what they were talking about. I'm not sure what the membranes rupturing means.

My husband, Kelley, and I lost our son, Christopher, at 22 weeks on July 4th this year. So much of your story is similar to mine. Everything was fine, a perfect ultrasound on June 31st - when we found out Chris was a boy. That was friday. Wednesday I felt a little pressure down there. Friday woke up with some blood and watery discharge - went in to the local ER and was taken to labor and delivery triage. They did an ultrasound and found out my fluid levels in the sac were a 8 - on a scale of 6 to 25, I was dialated to a 3, part of my amniotic sac had slipped through my cervix and had hour-glassed, and while the tech was doing the ultrasound Chris had even kicked his foot through my cervix.

We too fought to save our baby, we refused to give up without a fight. The doctors wanted us to induce right away - the risk of infection was too great in their opinion. My OB however let us at least fight to TRY to save him. They pumped me with antibiotics and liquids hoping to replenish the fluid and prevent infection. We also had me in the trendulberg (I think) position where my feet were higher than my head hoping that gravity might pull the sac back in.

Things had started looking good for us. I had no temp, Chris heartbeat was still going strong, the blood had almost stopped and so had the fluid. The nursing staff and our friends and families were all praying this was good news.

Then came the ultrasound - the fluid was even lower, and more of the sac was out, then I started showing signs of infection, my temp going up and some blood test didn't look good too.

We fought my body, we fought nature, we prayed to God, and apparently Chris was too good for this world. I was induced and delivered my Christopher at 12:51am on July 4th.

~break for my tears~

I have done a lot of research since this happened and I was told about the incompetent cervix. I was told that they can place a cerclage in between 10-14 weeks, which is basically where they stitch your cervix closed so it won't open. They wait for it so that if you were going to miscarry for other reasons that's about when that risk is over with. There is a very high success rate with the cerclages. There are risks like your cervix getting torn, having it put in can cause preterm labor, infection, all of that, but it gives your cervix the strength it needs. They also (for me I was told today) would start shots at 16 weeks to help the babies body strengthen their lungs and such so if they are born early they have a better chance. They would measure my cervix weekly and if it starts changing I would be put on extreme bedrest. They would give me meds to make sure I don't have contractions until a certain point. The most common cerclage is then taken out at a certain point - around 36 weeks - so that when you do go into labor your cervix isn't torn because of the stitch.

I can't swear that this is what happened to you, your doctors would know better. You found out about other problems too, but your story resembled mine in so many ways I had to mention the IC - it's something you may want to ask about.

I am soo sorry for your loss, and wish you the best in TTC again. Hubby and I were told to wait 2 cycles, one of which is past. We want to TTC as soon as we can again.

Christopher will never be replaced, and I pray every night that he knows that our wanting to try again doesn't mean we are replacing him. Maybe God sent us Chris so that our future babies are born healthy and we know about my cervix problems. I'm still fighting all sorts of demons from losing Chris. The guilt, the pain, the anger at God; but we still want a child of our own. God showed us that after 8 years we can conceive.

I hope I haven't said too much - I tend to do that. Feel free to PM me if you'd like - if you want to read the whole in detail story you can visit our blog at www.doernbaby.blogspot.com Just be forwarned that there are pictures of our Chris in a blog after the one telling the story of the loss.

I had to share this because the stories sounded so similar and to let you know if it is IC - incompetent cervix - there are other options and more help out there. Someone also shared the following link with me and it's for people with IC. http://www.ic.hobh.org/forums/

Hugs,
Tammy

AngieLong328 · 08-08-2009, 11:06 PM

In response to your questions our loss happened this past June(4th)- this ( August) is our fist month to start trying again. As far as my doctors go- they never really said anything other than "they dont know." They don't know if was infected then ruptured or if I had incmpetent cervix and that caused the rupture or if know there was a problem related to the clotting disorder. All they will say is that they just don't know- which is extremely aggrevating. The group that delivered our baby (Hannah) said they would only do serial cervical lengths. Since that time I have spoken to a new ob/gyn who is very kind- she basically said they would do the cervical lengths to monitor for shortend cervix and also test for fetal fibronectin( a vaginal swab that somehow is a predictor for preterm delivery.) She also said they would watch me each week from 20- 24 weeks to monitor the baby. I have a family friend who is ob/gyn- also suggested the progesterone injections starting at 16 weeks. The ob/gyn here in town said she did not think that was necessary, but if that is what I wanted she would write the prescription for it. I think I will ask for them. I told her that I felt I needed to everything possible to protect this future pregnancy and that I don't think I could survive another exp. like this one. So, she said she would act as a sounding board and as long it would not hurt me or the baby she would agree. She says that she doesnt want me to have to live with any regret. I totally agree! I can only imagine that I will be a paranoid crazy mess next time around- thank you for sharing your story- there is alot of comfort knowing that there are other people that have been through the same ordeal.

lilredheadgirl · 08-09-2009, 02:27 AM

I am so, so sorry for your loss and I understand your fear about future pregnancies. I'm glad that you've found a new OB who will give you additional tests an monitoring during your next pregnancy - you will need that, for your baby's sake and for your own peace of mind! Even if you never do get answers as to why you lost this baby.

We believe we lost our daughter due to an umbilical cord accident (the cord was wrapped around her neck four times), which is heartbreaking because there's absolutely nothing you can do to prevent that. Everything had gone perfectly up until that point. And yet, the doctor who delivered her said that even in our case, she would treat my next pregnancy as high risk and give me extra monitoring and attention. These fears you are feeling (and I feel them too, even though we're not even TTC again yet) are perfectly natural and I'm glad you've found a new OB who seems to understand them.

Best of luck to you!

AngieLong328 · 08-09-2009, 02:45 AM

I can not imagine how awful that must have been for you! I agree, that sometimes having a "treatable" problem is easier to cope with. I never really thought or imagined how bad things can get so fast. You go one day to the doctor and a perfectly healthy babyand then all of the sudden it is dead. I don't think many people even have this in their thoughts unless they hav exp. it for themselves. I am so sorry for your loss and I hope and pray that you do not ever have to suffer like that again!

reneej · 08-09-2009, 05:50 AM

I too was diagnosed with an incompetent cervix in my 4th month. I was placed on bedrest and the doctor inserted a cerclage that held the baby. Successfully my baby girl was born full term. This was 5 years ago. My husband and I had been trying to conceive again and luckily in early May I discovered I was pregnant. However, on June 16th I had a DNC because of a miscarriage. I am still waiting for my cycle so that we can try again. Trust me, there is no way to avoid thinking about the "what ifs" when you're pregnant. Just keep trying and have faith. I wish you the best of luck....maybe we'll get lucky around the same time

lilredheadgirl · 08-09-2009, 06:16 AM

Thanks, Angie, and I hope for the same for you. I think identifiable, treatable complications are senseless too. Either way, I know exactly what you mean, how one minute everything is fine, everyone's perfect and healthy, and the next the worst has happened. I think one of the things we've lost as a result is a certain innocence and ability to have a carefree pregnancy in the future. But we just have to do our best, right? I sincerely wish you luck!

dstaiger · 08-11-2009, 12:17 AM

i too was due in october. at 16w i went into labor. it was too early for steroids and magnesium. my cervix was fine, my placenta was fine. i labored for hours and delivered a my tiny son.

that was april 21st. we started ttc june 21st and conceived immediately.

my son died 3 1/2 months ago and i'm 2 months pg. i'm scared to death.

i grieve for my son daily.

i plan for the future.

i'm seeing a peri who wants me to start progesterone injections in the second tri. it's the only hope i have to prevent PTL.

there is no secret. take a deep breath and decide to hope.

AngieLong328 · 08-11-2009, 09:33 PM

Dianna,
August is our first month to try again. I got pg with Hannah using only Femara and a trigger shot- this time a round we are doing femara, repronex, and a trigger shot. My RE claims it is easier to conceive within the first six months after a loss. So we want to try to make the most of our time. I am glad you mentioned the progesterone. Like I posted previously- here in TN most of the ob/gyn's only write for progesterone injections once you have gone into preterm labor and they are trying to hold off contrasctions on a viable baby. A family friend who is a ob/gyn said that she thought I would a candidate for the injections. My new ob says she doesnt think it is necessary, but she would let me do the shots if I wanted- I thin I will def- do them.

PS- to all previous posters... ARe you going to try again soon... if you do let me know how it goes!

dstaiger · 08-11-2009, 10:31 PM

last time i let the drs do what they thought was best. this time i know what can go wrong and have decided to be my own advocate. i will demand the treatment i think i need and fight the drs and insurance co till the very end.

they may think i'm crazy but this time either things will work out the right way, or i'll know i did everything and have no regrets.

good luck ttc. their right when they say you get pg again more easily. i o'd while on prometrium to start a cycle, and 12 days later a bfp. i never expected it to go that fast.

i'll keep my fingers crossed and let us know how it goes!

reneej · 08-12-2009, 03:19 AM

Does the progesterone injections work the same as the inserts? My doctor put me on the pro. inserts the first couple of weeks of my pregnancy. For my first prenancy it was successful but not for the second. With the change of hormones from PCOS what can we do to ensure a healthy pregnancy that will carry to term?

AngieLong328 · 08-12-2009, 01:53 PM

From what I could find out it does seem to help prevent pre term labor. There are a couple things to consider... It seems to only help in singleton pregnancies, and you need to start at approx. 16 weeks b/c it does not appear to help all women once the cervix has started to shorten. Like I mentioned in the previous post the doctors here in Knoxville give this typically after a women is hospitalized to pre term contractions. Once she is "stable" and on bedrest they begin getting the injections. If you google it there is a ton of info about it... I tried find a website from UNC ( they are doing research on this) but I could not find it right away. Also, I was on progesterone supp. until 10 weeks with Hannah. My ob said the injections are treating a different phase of the pregnancy. She says the supp. are to help luteal phase defect or a egg that has been assisted in the process. I don't know what is the right answer, but if it won't hurt me and the baby I am willing to give it a try!

SheriKCMO · 08-22-2009, 12:22 AM

I am so sorry to everyone on this thread with losses! If you ever want to stop by the loss forum to chat, please don't hesitate to post your story and do some venting. (((((Hugs)))))

Angie, it's my paranoid opinion, but one from a lot of experience, that anyone experiencing painless dilation is a candidate for a preventative cerclage. If you are also positive for the antibodies that require medication, go for that too. And the progesterone if you feel like it can help. My cervix was soft at 13 weeks when my cerclages were placed, so my OB confirmed that we needed them, and I didn't end up needing bed rest because they did such a good job for me. Very best wishes to you, whatever you decide!

Peaches20nash · 08-22-2009, 01:30 AM

I'm so sorry for your loss It will always be scary just because you lost a child especially in that way. Its scary for women who have normal pregnancies Just remember if you do get pregnant again try not to stress to much about the past